Individual
MS. ADRIAN BROADWAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
REGISTERED NURSE
Contact information
Practice address
103 LONG CREEK WAY, GROVETOWN, GA 30813-5275
(706) 951-4262
Mailing address
103 LONG CREEK WAY, GROVETOWN, GA 30813-5275
(706) 951-4262
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN184223
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN184223
NURSING LICENSE
GA
Enumeration date
01/24/2022
Last updated
01/24/2022
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